Provider Demographics
NPI:1467405837
Name:PARKCREEK SURGERY CENTER LLLP
Entity Type:Organization
Organization Name:PARKCREEK SURGERY CENTER LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FAMIGLIETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-312-3507
Mailing Address - Street 1:6806 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4304
Mailing Address - Country:US
Mailing Address - Phone:954-312-3507
Mailing Address - Fax:954-312-3207
Practice Address - Street 1:6806 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4304
Practice Address - Country:US
Practice Address - Phone:954-312-3507
Practice Address - Fax:954-312-3207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical